Partners

Task Force Finding

The Community Preventive Services Task Forcerecommends quitline interventions, particularly proactive quitlines (i.e. those that offer follow-up counseling calls), based on strong evidence of effectiveness in increasing tobacco cessation among clients interested in quitting. Evidence was considered strong based on findings from 60 trials of proactive telephone counseling when provided alone or in combination with additional interventions.

Three interventions effective at increasing use of quitlines are:

Mass-reach health communication interventions that combine cessation messages with a quitline number

Evidence also indicates that quitlines can help to expand the use of evidence-based services by tobacco users in populations that historically have had the most limited access to and use of evidence-based tobacco cessation treatments.

Intervention Definition

Quitlines use the telephone to provide evidence-based behavioral counseling and support to help tobacco users who want to quit. Counseling is provided by trained cessation specialists who follow standardized protocols that may include several sessions delivered over one or more months.

Quitline counseling is widely accessible, convenient to use, and generally provided at no cost to users. Content may be adapted for specific populations, and tailored for individual clients. Counseling may be:

About the Systematic Review

The Task Force finding is based on evidence from a systematic review published in 2009 (Stead et al., search period through March 2009) combined with more recent evidence (search period March 2009 - July 2012). The systematic review was conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice, and policy related to reducing tobacco use and secondhand smoke exposure. This finding updates and replaces a previous Task Force finding on Multicomponent Interventions that Include Telephone Support.

Results

Seventy-two studies were included in this review (65 from Stead et. al., 2009 and 7 from the more recent search). Of these studies, 60 evaluated effectiveness of proactive telephone counseling.

Six studies used different outcome measures that could not be compared.

To supplement findings on quitline effectiveness, the Task Force considered additional evidence from 49 studies that evaluated interventions to promote quitline use (search period January 2000 – July 2012).

Rather than examine overall changes in quitline call volume, most of these studies found increases in the number of quitline referrals from participating clinical settings. In one study from Wisconsin, fax referrals accounted for 30% of the 12,000 annual quitline callers (Perry et al. 2005).

Economic Evidence

Twenty-seven studies were included in the economic review. Twelve studies provided 13 estimates of cost-effectiveness measurements of different quitline services. All monetary values from studies are reported in 2010 U.S. dollars.

Cost-effectiveness of providing quitline counseling and cessation information: median estimate of $2,012 per quality-adjusted life year (QALY) saved (range of values: $439/QALY to $2,627/QALY; 6 studies)

Estimates of cost-effectiveness were assessed in comparison to a conservative threshold of $50,000 per QALY saved. Overall, the economic evidence indicates that quitline services are cost-effective across a range of different treatments and promotional approaches.

Publication Status

Full peer-reviewed articles of this systematic review will be posted on the Community Guide website when published. Subscribe to be notified when we post these publications or other materials. See our library for previous Community Guide publications on this and other topics.

Disclaimer

The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.

Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Reducing tobacco use and secondhand smoke exposure: quitline interventions. www.thecommunityguide.org/tobacco/quitlines.html. Last updated: MM/DD/YYYY.